The present invention relates to a drainage tube for creating permanent access to sinus maxillaris during a desired length of time, particularly for drainage of the sinus maxillaris. Sinus maxillaris is often alone or in combination with other paranasal sinuses a seat for infections resulting in suppuration collection with accompanying pain, soreness and weight feeling. The treatment of such infections is firstly directed to drainage of the suppuration collection through puncture of the sinus maxillaris and sucking-out of the suppuration and/or flushing thereof. This therapy must, usually in combination with medicine treatment, often be repeated several times before the infection has been removed.
Puncture and flushing of sinus maxillaris usually takes place in such a manner that after local anaesthesia of the nasal mucosa a sharp needle is inserted into the nose below the inferior coucha. The needle is forced with great force through the bone wall into the sinus maxillaris. Possibly, a portion of the suppuration is thereafter sucked out for diagnosis and bacterium culture, whereupon the remaining suppuration can be flushed out through the normal, but owing to the infection often closed, ostium of the sinus maxillaris. The above described treatment is troublesome for the patient, particularly when it must be repeated several times before the infection is healed and disappeared. Moreover, many patients have disposition for recurring infections which require accompanying new treatments. These patients stand the risk of developing chronic infections and inflammations which in the end require radical surgical evacuation of sinus maxillaris.
Summing up, the means for current treatment of acute and chronic purulent infections in sinus maxillaris are unsatisfactory for the following reasons:
1. Puncture and flushing must be often repeated.
2. Gives only temporary recovery and must almost always be combined with antibiotic treatment.
3. Does not prevent new infections.
There are also on the market some different types of drainage which, however, are all intended for short use in connection with acute infection. These drainages consist of a hose having a few millimeters in diameter, which hose with the aid of a needle is forced through the bone wall into the sinus maxillaris. The hose is applied in such a manner that it gives the possibility to flush the sinus maxillaris during some time without the need for braking up a new hole for each time. By different arrangements, the hose is prevented from falling out of sinus maxillaris.
Besides the disadvantage of only being intended for short use in connection with acute infection, these drainages with hoses have other disadvantages deriving from the manner to apply the hose, as well as from the shape and the dimension thereof.
These problems have led to the development of the present invention, and by the invention the following advantages are obtained:
1. The drainage can be applied in a manner which is almost entirely pain-free and liniant for the patient.
2. The diameter of the drainage is such that a continuous discharge of suppuration and secretions and inflow of air can take place unprevented. The drainage allows the possibility of sucking out suppuration and secretions as well as, when need arises, flushing sinus maxillaris.
3. The configuration and the application is such that the drainage can be maintained during a long time, and not only cure acute infections, but also prevent new infections by providing for continuous out-flow and circulation of air.
4. The drainage allows the insertion of fibre optical equipment.
In order to obtain the above mentioned advantages, the present invention relates to a drainage tube for the application in a hole made in the bone wall between sinus maxillaris and nasal cavity for treatment of infections in sinus maxillaris and arranged for permanent application on the bone wall during the entire treatment time before its removal by extraction. The characteristics of the drainage tube according to the invention appear from the enclosed claims.
When using a drainage tube according to the invention it is essential that the hole in the bone wall between sinus maxillaris and nasal cavity is made with correctly adapted dimension to the drainage tube and that bone wall pieces and flakes are prevented from coming into sinus maxillaris. The invention also includes a hole making instrument which, as distinguished from previously known instruments being pushed through the bone wall, consists of a drill which drills out a bone plug which is caught in the instrument and removed when the hole is finished. This drill according to the invention is pre-shaped and is in its free end, formed as a circular cutter.
Also the insertion and the application of the drainage tube are of essential importance. The invention also provides particular instrument for correct application of the drainage tube. This instrument is characterized in that it is tube-formed having an exterior dimension adapted to the dimension of the hole in the bone wall and an interior dimension adapted to the dimension of the middle portion of the drainage tube, wherein the free end portion of the instrument is formed to hold the extensible end portion of the drainage tube in an unextended position corresponding to the dimension of the exterior dimension of the middle portion and having a part of this end portion projecting out of the free end of said end portion of the instrument. The instrument is provided with support means for abutting the surface of the collar-like end portion of the drainage tube being faced away from the extensible end portion.